Preeclampsia (PE) is a pregnancy-specific hypertensive disorder and a leading cause of maternal and perinatal morbidity and death worldwide. World Health Organization (WHO) estimates that 16% of global maternal mortality (˜63,000 maternal deaths annually) is due to PE alone. In the U.S., preeclampsia affects 5-8% of all pregnancies or 270,000 women and is responsible for 18% of maternal deaths each year and the occurrence is rising. Infants are also at risk; 10,500 babies die each year due to preeclampsia in the US. Preeclampsia is diagnosed based on observed symptoms. There is no accurate diagnostic product for preeclampsia.
The risk of maternal death is much higher in resource-limited settings. The most often recognized factor responsible for major maternal and fetal morbidity is failure to recognize preeclampsia in a timely manner. This is a major obstacle because it does not allow for transfer of the woman with preeclampsia to a higher level health care facility where she can be managed with magnesium, steroid therapy and/or emergent delivery prior to eclampsia, maternal hypertensive stroke or fetal death due to abruption. Preeclampsia is an evolving condition. Therefore, improving detection of preeclampsia in women who are clinically asymptomatic or questionably symptomatic for preeclampsia will be of significant clinical importance. This strategy is known as secondary preeclampsia prevention, and has the potential of reducing pregnancy-related mortality and morbidity by preventing eclampsia and damage to end-organ systems due to convulsions, stroke, pulmonary edema, liver and/or kidney failure and maternal death.
Once severe preeclampsia (sPE) is diagnosed, magnesium sulfate, antihypertensive drugs and medically indicated delivery are effective strategies that have already proven lifesaving (strategies known as tertiary preeclampsia prevention). For preterm pregnancies, correct timing of medically indicated delivery to allow for conservative management (e.g., steroids) is also known to improve neonatal outcomes. The use of therapeutic strategies for prevention of preeclampsia complication is conditioned by the accurate diagnosis of this condition.